Digoxin Flashcards
Brand name(s)
Lanolin, Toloxin
Action
Increase force of myocardial contraction, prolongs refractory period of the AV node, decreases conduction through the SA & AV nodes
Therapeutic Effects
Increased CO, slowing of heart rate
Adverse Reactions/SE
Bradycardia, anorexia, nausea/vomiting, acute digoxin toxicity with electrolyte imbalances, fatigue
Route/Dosage
PO maintenance dose 0.125-0.5 mg/day depending on patient’s lean body weight, renal function, and serum levels
Contradictions/Precautions
Hypersensitivity; uncontrolled arrhythmia; electrolyte imbalance can lead to increase risk of toxicity: such as with hypokalemia, hypercalcemia, and hypomagnesemia; Diuretic use may cause electrolyte imbalances; hypothyroidism; MI; renal impairment
Interactions
Hypokalemia may increase risk of toxicity with loop diuretics, bradycardia may occur with beta blockers
Evaluation & Desired Outcomes
Decrease in severity of HF, Increase in CO, decrease in ventricular response in atrial tachyarrythmias, termination of paroxysmal atrial tachycardia
Nursing implications/implementation
Monitor apical pulse before administration, withhold and notify MD if less than 60 bpm or if any changes to rate, rhythm or quality of pulse. Monitor I&O and daily weights. Assess for edema and breath sounds (evaluation for rales/crackles) observe for symptoms of toxicity (initially present as GI Sx such as N/V, late Sx fatigue, vision changes, Altered LOC)
Patient/Family Teaching
Show pt and family how to take pulse and to assess before taking medication. Contact MD if rate less than 60 or greater than 100. Review Sx if digitalis toxicity and HF with pt. Notify MD of any new medications prescribed or OTC. Avoid antacids or antidiarrheals 2 hours prior to digoxin
Class
Antiarrhythmics, Inotropics, digitalis glycoside
Therapeutic range
0.5 - 2 ng/mL
